Clinical utility of randomized controlled trials of regional anesthesia for lower-extremity surgery: a systematic review

Regional anesthesia (RA) is central to multimodal analgesia, yet many supporting randomized controlled trials (RCTs) may lack the rigor needed for evidence-based block selection.

To evaluate the clinical usefulness and transparency of RCTs investigating RA interventions for lower extremity surgeries, using the van 't Hooft et al framework.

Embase/MEDLINE were searched for RCTs (2014-2024) examining RA interventions for lower-extremity surgery. Data were extracted in duplicate using clinical-utility and transparency criteria. Analyses included descriptive statistics, linear regression for temporal trends, Pearson correlation, and multivariable regression to identify predictors of usefulness.